HomeMy WebLinkAboutSPI2024-00050 - SPI Application - 5/9/2024 MASON COUNTY RECEIVED sP1 2o2-4 - c o';n
COMMUNITY SERVICES
Building,Planning,Environmental Health,Community Health MAY 0 9 2024 PLANNER - 6 C+V;!1
615 W.Alder St.—Bldg.8,Shelton,WA 98584
Phone:(360)427-9670 ext.352♦Fax:(360)427-77A 15 w Alder vb'e'
PLEASE PRINT $300.00 FEE REQUIRED
PLANNING DEPT. PRE-INSPECTION APPLICATION
Note: Pre-inspection does not survey lot lines and can only provide very general septic and water adequacy informati
I CP"rr>�r c.-c n+aEr)
1. Owner: ,4-e_Dhen j2 A^ �'ma 0Applicant: I '`2 ca V-1 d4i iouy-)�cin4e Sk1 k
Site Address: Applicant Addr6s: I R 14 T�*Ny-Mew S� N E
Owner Address: City: Olympia St �N A Zip 985L-Yp
City: St Zip Phone 2 2Co—I-q CXo S day
Phonc:(340) SM- 5Rej!' Email Address: l ,Lorn
Email:
(if different than applicant) Legal Description: T IZZ of= Sw SC— F x
2. Parcel No. '+Z 022 - C O P�kJ
y-3
Parcel No. - -
3. Purpose of Pre-Inspection:
4. Use of building: CI,Uwl/h_
5. `e. Do any of the following exist on or adjacent to property?: slope saltwater ) lake( river )
�, pond( ) wetland( ) seasonal runoff( ) other ) stream( ) seasonal creek(
Directions to Site: C(CrcSS +kp— ,54rLae-4 -Fm rn 3ft7 W She 14W M 0410ck P—J-
If the information is incomplete, then Mason County must disclaim any errors resulting from deficiencies in the original
application. Pre-inspection reports remain valid only until development changes occur in the vicinity which affect the lot
evaluated in this inspection, or the laws r ting development of the site change after the time of inspection.
Applicant Signatur Date: S lql2q
If you would like to be on site during inspection,please check here: ( )
Return application to: Mason County Community Services,Planning Division
615 W. Alder Street
Shelton, WA 98584
(360)427-9670 ext. 352
Please include a$300.00 check or money order payable to Mason County Treasurer
When completed, this form becomes part of the parcel file.
FOR OFFICE USE ONLY: Accepted by: Date:
MORE ON BACK SIDE
Rev. April 2021
Mason County WA GIS Web Map
1�114
U�
7
<f�
1¢
5/7/2024, 11:35:19 AM 1:3,072
_ 0 0.03 0.05 0.1 mi
J County Boundary
0 0.04 0.08 0.16 km
❑ No Filled
Tax Parcels (Zoom in to 1:30,000)
Sources:Esri,HERE,Garmin,Intennap,increment P Corp.,GEBCO,USGS,
FAO, NPS, NRCAN, GeoBase, IGN, Kadaster NL, Ordnance Survey, Esri
Japan,METI,Esri China(Hong Kong),(c)OpenStreetMap contributors,and
the GIS User Community
Mason County WA GIS Web Map Application
Mason County disclaims accuracy,reliability,or timeliness of websile info,not liable for losses from reliance on it,hftps://www.masoncountywa.gov/disclaimer.php